March 31, 2010 - Data for pregnant women on the Big Island [Hawaii] suggest about half of the island's 37,892 children under age 18 were exposed before birth to alcohol, tobacco and illicit drug use, researchers report. The findings also indicate that of about 2,200 deliveries on the island each year, almost 1,100 infants are born exposed.

Dr. Ira Chasnoff is a professor of clinical pediatrics at the University of Illinois College of Medicine, and president of the Children's Research Triangle in Chicago.A fellow of the American Academy of Pediatrics, Dr. Chasnoff is renowned for many years of research on the potential effects of maternal drug use on long-term child development. Dr. Chasnoff is conducting a federally funded project in Hawaii that involves a comprehensive system of screening, assessment and brief intervention for pregnant women from some physicians and public health clinics, including private pay and Medicaid patients. The nonprofit organization is concerned with healthy development of children and families.

Dr. Chasnoff: "Research shows 60 percent of prenatally [before birth] exposed children end up in jail," adding that programs he developed for children in Chicago have significantly reduced that rate.

Their findings are reported in "The First 1,000 Women; Perinatal Substance Use on the Hawaii Island." The rate of cigarette smoking among native Hawaiian women was 43.1 percent, and 64.6 percent continued smoking after learning they were pregnant.Native Hawaiian women had the highest rates of smoking and Caucasian women the highest rates of alcohol and marijuana use in the month before they knew they were pregnant. All groups tended to stop substance use after learning they were pregnant, but 64.6 percent of Hawaiian women continued to smoke and 45 percent of Caucasian women continued to drink alcohol. Substances also were used by 48 percent of the pregnant Asian women, 30 percent of Filipino women and 53 percent of women of mixed race.

Loretta Fuddy, chief of the state Health Department's Family Health Services Division, said Chasnoff's figures are a little higher than the department has seen through its perinatal risk assessment survey. She said the important thing about Chasnoff's work is that he provides a model for intervention by physicians to try to prevent adverse effects. The Health Department has a perinatal network and provides funding to community health centers to screen high risk women for alcohol, smoking, illicit drug use and domestic violence, she said. The agency also is working with the child welfare system to provide early intervention services for children under age 3, Fuddy said.